The role of non-invasive ventilation in weaning and decannulating critically ill patients with tracheostomy: A narrative review of the literature
Miguel Guia,
Laura D Ciobanu,
Jithin K Sreedharan,
Mohamed E. Abdelrahim,
Gil Gonçalves,
Bruno Cabrita,
Jaber S. Alqahtani,
Jun Duan,
Mohamad El-Khatib,
Montserrat Diaz-Abad,
Jakob Wittenstein,
Habib M.R. Karim,
Pradipta Bhakta,
Paolo Ruggeri,
Giancarlo Garuti,
Karen E.A. Burns,
Guy W. Soo Hoo,
Raffaele Scala,
Antonio Esquinas
Affiliations
Miguel Guia
Pulmonology Department, Hospital Professor Doutor Fernando Fonseca, IC19, 2720-276 Amadora, Lisbon, Portugal; Corresponding author at: Rua Tenente General Zeferino Sequeira, number 20, 13ºA, Carnaxide, Lisbon, Portugal.
Laura D Ciobanu
Clinical Hospital of Rehabilitation, Iasi University of Medicine and Pharmacy “Grigore T Popa”, Strada Universității 16, Iași 700115, Romania
Jithin K Sreedharan
Prince Sultan Military College of Health Sciences, Al Amal Dhahran 34313, Saudi Arabia
Mohamed E. Abdelrahim
Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Qism Bani Sweif, Bani Sweif, Beni Suef Governorate, Egypt
Gil Gonçalves
Pulmonology Department, Centro Hospitalar e Universitário de Coimbra, Praceta, R. Prof. Mota Pinto, 3004-561 Coimbra, Portugal
Bruno Cabrita
Pulmonology Department, Hospital Pedro Hispano, R. de Dr. Eduardo Torres, Sra. da Hora, Matosinhos, Portugal
Jaber S. Alqahtani
Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Al Amal, Dhahran 34313, Saudi Arabia
Jun Duan
Department of Respiratory and Critical Care Medicine, The first Affiliated Hospital of Chongqing Medical University, 275 Jinlong Rd, Longxi, Yubei District, Chongqing, China
Mohamad El-Khatib
Department of Respiratory Therapy, American University of Beirut - Medical Center, Beirut, Lebanon
Montserrat Diaz-Abad
Department of Medicine, University of Maryland School of Medicine, 655 W Baltimore St S, Baltimore, MD 21201 USA
Jakob Wittenstein
Department of Anesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus, Fetscherstraße 74, 01307 Dresden, Germany
Habib M.R. Karim
Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Great Eastern Rd, AIIMS Campus, Tatibandh, Raipur, Chhattisgarh 492099, India
Pradipta Bhakta
Department of Anaesthesia and Intensive Care, Cork University Hospital, Wilton, Cork, Ireland
Paolo Ruggeri
Pulmonology Unit, Department of Biomedical and Dental Sciences, Morphological and Functional Images (BIOMORF), University of Messina, Piazza Pugliatti, 1, 98122 Messina ME, Italy
Giancarlo Garuti
Pulmonology Unit, Santa Maria Bianca Hospital, Mirandola, AUSL Modena, Via S. Giovanni del Cantone, 23, 41121 Modena MO, Italy
Karen E.A. Burns
Interdepartmental Division of Critical Care Medicine, University of Toronto, 27 King's College Cir, Toronto, ON M5S, Canada
Guy W. Soo Hoo
Pulmonary, Critical Care and Sleep Section, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
Raffaele Scala
Pulmonology Department an RICU, San Donato Hospital, Via Pietro Nenni, 20/22, 52100 Arezzo AR, Italy
Antonio Esquinas
Intensive Care Unit, Hospital Morales Meseguer, Av Marqués de los Vélez, s/n, 30008 Murcia, Spain
Introduction: Invasive mechanical ventilation (IMV) is associated with several complications. Placement of a long-term airway (tracheostomy) is also associated with short and long-term risks for patients. Nevertheless, tracheostomies are placed to help reduce the duration of IMV, facilitate weaning and eventually undergo successful decannulation. Methods: We performed a narrative review by searching PubMed, Embase and Medline databases to identify relevant citations using the search terms (with synonyms and closely related words) “non-invasive ventilation”, “tracheostomy” and “weaning”. We identified 13 publications comprising retrospective or prospective studies in which non-invasive ventilation (NIV) was one of the strategies used during weaning from IMV and/or tracheostomy decannulation. Results: In some studies, patients with tracheostomies represented a subgroup of patients on IMV. Most of the studies involved patients with underlying cardiopulmonary comorbidities and conditions, and primarily involved specialized weaning centres. Not all studies provided data on decannulation, although those which did, report high success rates for weaning and decannulation when using NIV as an adjunct to weaning patient off ventilatory support. However, a significant percentage of patients still needed home NIV after discharge. Conclusions: The review supports a potential role for NIV in weaning patients with a tracheostomy either off the ventilator and/or with its decannulation. Additional research is needed to develop weaning protocols and better characterize the role of NIV during weaning.
